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目的 :通过检测干扰素抗体、HCV基因分型、治疗前后血清HCV -RNA量及淋巴细胞亚群 ,探讨干扰素疗效的预测因素。方法 :ELISA方法检测干扰素抗体 ,抗病毒中和生物鉴定法进行干扰素中和抗体检测。用MTT检测干扰素中和抗体的滴度。进行HCV基因分型及血清HCV -RNA定量检测。采用APAAP免疫桥联酶标法检测T淋巴细胞亚群。结果 :(1 )HCV -Ⅲ型感染者完全应答率较HCV -Ⅱ型高 ,P<0 0 5。 (2 )完全应答组治疗前血清HCV -RNA量明显低于部分应答和无应答组。 (3)部分应答组干扰素抗体阳性率明显高于完全应答组 ,P<0 0 5。中和抗体对干扰素疗效的影响与抗体的滴度有关 ,抗体滴度高干扰素疗效差。 (4)各组间淋巴细胞亚群变化无统计学差异。结论 :(1 )治疗前血清HCV -RNA低水平是对干扰素治疗产生完全应答的一个重要的预测指标。 (2 )HCV -Ⅲ型患者对干扰素治疗的完全应答率明显高于HCV -Ⅱ型。但可能受血清HCV -RNA水平的影响。 (3)干扰素抗体 ,特别是中和抗体是影响干扰素疗效的因素之一 ,治疗过程中检测干扰素抗体是预测干扰素疗效的指标之一。 (4)外周血淋巴细胞亚群不能作为预测干扰素疗效的指标。
OBJECTIVE: To explore the predictors of efficacy of interferon by detecting interferon antibodies, HCV genotyping, serum HCV-RNA levels and lymphocyte subsets before and after treatment. Methods: Interferon antibody was detected by ELISA, and neutralization antibody was detected by antiviral neutralization bioassay. The titer of the interferon neutralizing antibody was measured by MTT. HCV genotyping and serum HCV-RNA quantitative detection. T lymphocyte subsets were detected by APAAP immunohistochemistry. Results: (1) The HCV-Ⅲ infection had a higher complete response rate than HCV-Ⅱ, P <0 05. (2) The serum HCV-RNA level in the complete response group before treatment was significantly lower than that in the partial response and non-response groups. (3) The partial positive rate of interferon antibody in response group was significantly higher than that of the complete response group, P <0 05. The effect of neutralizing antibody on the efficacy of interferon is related to the titer of the antibody, and the antibody titer is high and the efficacy of interferon is poor. (4) There was no significant difference in lymphocyte subsets between groups. Conclusions: (1) Pretreatment serum HCV-RNA low level is an important predictor of complete response to interferon treatment. (2) The complete response rate to interferon therapy in HCV-III patients was significantly higher than that in HCV-II patients. But may be affected by serum HCV-RNA levels. (3) Interferon antibodies, especially neutralizing antibodies, are one of the factors affecting the efficacy of interferon. Detection of interferon antibodies during the treatment is one of the indicators to predict the efficacy of interferon. (4) peripheral blood lymphocyte subsets can not be used as an index to predict the efficacy of interferon.